Multiple liver focal fat sparing lesions with unexpectedly increased (18)F-FDG uptake mimicking metastases examined by ultrasound (18)F-FDG PET/CT and MRI.

ABSTRACT

UNLABELLED Focal fatty liver disease is less common than the diffuse form and may be misdiagnosed as nodular liver lesions or even liver metastases. Here, we report a 19 years old male, asymptomatic with liver lesions detected by ultrasound on routine examination. Further examinations with computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography/CT (PET/CT) showed multiple lesions of varying sizes on the liver, with elevated fluorine-18-fluorodeoxyglucose ((18)F-FDG) uptake (SUVmax 4.8-12.5). The diagnosis of metastases or lymphoma was made. IN CONCLUSION: Histopathology diagnosed focal fatty sparing lesions in the liver. This pattern presented difficult diagnostic challenge. The pathogenesis of multifocal fat deposition and the reasons of the higher accumulation of (18)F-FDG in the liver fat lesions have not been up to now fully explained.